Abstract: :
Purpose: During vitreoretinal surgery on aphakic eyes with absentposterior capsule, the turbulent flow of irrigation may causecorneal edema and Descemet's membrane folds. We studied whethersodium hyaluronate (Healon) has a protective effect on the cornealendothelium during vitreoretinal surgery.Methods: In a prospectiveclinical trial, 83 aphakic eyes with absent posterior capsuleunderwent vitreoretinal surgery. These eyes were divided intwo groups, Group 1: the anterior chamber was filled with sodiumhyaluronate before starting vitrectomy (n=66), Group 2: vitrectomywithout sodium hyaluronate in the anterior chamber (n=17). Atthe end of surgery sodium hyaluronate was flushed with balancedsalt solution from the anterior chamber into the vitreous cavityand then was aspirated. Central corneal thickness was determinedby ultrasound pachymetry before surgery and again 2 days aftersurgery.Results: The incidence of severe corneal edema was7.7% in the sodium hyaluronate group and 38.5% in the controlgroup for the surgeries lasting less than 2 hours (P=0.012).In surgeries longer than 2 hours severe corneal edema was 21.4%in the sodium hyaluronate group and 100% in the control group(p=0.011).Conclusions: Filling the anterior chamber with sodiumhyaluronate is effective in protecting the corneal endotheliumin vitreoretinal surgeries in aphakic eyes. Sodium hyaluronatesignificantly reduces the degree of corneal edema. This mayresult in better visualization during vitreoretinal surgeries.